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**International News**
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- "Mbeki           Resolute on AIDS Stance"  

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**Medical News**
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- "Tuberculosis           Morbidity Among US-Born and Foreign-Born Populations - United States,           2000"
- "Progress           Toward Elimination of Perinatal HIV Infection - Michigan, 1993-2000"  

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**News Briefs**
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- "World           Bank Gives African Countries $500 Million for AIDS Fight" 
- "AIDS           Researcher Donates $1 Million Prize to UBC Professorship" 
- "Local           AIDS Service Group Awarded $15,000 Grant" 

**"'I'm Not         Ashamed of My Opinions'"**topNewsweek         (web exclusive) 02.05.02 David France 

 Former US         Rep. Dr. Tom Coburn (R-Okla.) was appointed last month by President Bush         to co-chair, with Dr. Louis Sullivan, the Presidential Advisory Council         on HIV/AIDS. Coburn was recently interviewed about his religious beliefs,         his thoughts on condoms, and his ideas for the future of AIDS in America;         excerpts of the interview follow. 

Newsweek:         "Your expected appointment has sparked some angst among AIDS activists,         to say the least. Are you surprised?"

Coburn: "Not         particularly. I have a political career that's evident in Washington,         and I'm not ashamed of that career. It has not necessarily been one that         the gay community would support. But on this issue, there hasn't been         a time when I haven't positioned myself in a way that's supportive ultimately         to every community. I'm a straight arrow. What you see is what you get.         I'm not ashamed of my opinions, and I'll defend them. 

Newsweek:         "Talk to me about condoms." 

Coburn: "I'm         a realist. I would not ever recommend to one of my patients to have sex         with someone with HIV with a condom. Because I know the statistics. They         break. They slip. What we've done is not told the whole truth about condoms.         �My position is, if you can get people to use condoms perfectly, and you         can make sure they use them, and tell them what the risks are, and tell         them the breakage rates and slippage rates are, it's a good strategy."         

Newsweek:         "There's no consensus there. Almost everybody else disagrees with you         about this." 

Coburn: "I         don't think you should ever educate anyone on condoms unless you specifically         teach them how to use them, and what their failure rates are. Anywhere         else in medicine, if we fail to give informed consent, we're liable. The         assumption is, people won't know what to do with the information. And         that is the most arrogant position I have ever heard."

 Newsweek:         "Then you support only abstinence?" 

Coburn: "I         believe that monogamy is the answer to HIV infection. I understand that         people think I'm not a realist in this area. But I'm monogamous, and there         are hundreds and hundreds of millions of people out there that are monogamous."

 Newsweek:         "How about needle exchange programs - and the studies that show they reduce         infection rates?" 

Coburn: "First         off, IV-drug use is illegal. So I disagree with the assumptions of the         studies. And I disagree with needle exchange. I think it's failed compassion.         If you want to help somebody, help them get off drugs. Don't give them         clean needles. That is a poor substitute for eliminating HIV. That's a         personal opinion, again, that's not [necessarily] what the committee is         going to do." 

**"Evertz Seeks to Ease Fears of AIDS Community"**topBay         Area Reporter (San Francisco) (01.31.02) Matthew S. Bajko 
 In response         to recent concerns that the Bush administration's AIDS advisory council         will push a conservative agenda, the president's openly gay AIDS advisor,         Scott Evertz, said he wanted to form an ad hoc committee composed of community         members working in HIV/AIDS prevention and care. 
"It would         be an informal association of individuals who would keep the AIDS policy         office informed of what is going on in HIV prevention and care," said         Evertz, who is director of the White House Office of National AIDS Policy.         "I've been thinking for a long time how to involve people actually doing         the work - people who are energized by the process of working to influence         government." Evertz - who announced his plans for the ad hoc committee         at a joint meeting of San Francisco's HIV Health Services and HIV Prevention         planning councils on Jan. 24 - said it could be formed within months if         its creation is not mired in red tape. 
His announcement         came two days after Tom Coburn, a former congressman who questioned the         use of condoms as an HIV intervention tool, was appointed as co-chair         of the Presidential Advisory Council on HIV/AIDS [PACHA]. The other co-chair         is Dr. Louis Sullivan, who served as Health and Human Services Secretary         under the first President Bush. AIDS activists have not only expressed         concerns about Coburn but also the council's Executive Director Patricia         Funderburk Ware, a longtime proponent of abstinence-based sex education.         Ware will report to Evertz, who said the advisory council will not directly         control the Bush administration's policies on AIDS - he will. 
"[PACHA]         is designed to make recommendations and not to make policy," stated Evertz.         "The fact is there is one voice when it comes to policy in the Bush administration."         Evertz said he would like to see Medicaid reformed to better provide for         people living with HIV/AIDS. "We don't want to roll back the clock on         HIV/AIDS treatment and prevention," Evertz said. Nearly 50 members from         both councils met with Evertz to stress the importance of listening to         community planning groups when determining AIDS policies and funding.         

**"AIDS Strikes Disproportionately at Black Community"**topAssociated         Press (02.07.02) Bruce Smith 
 The AIDS         epidemic is disproportionately striking blacks in South Carolina. Almost         70 percent of those with HIV/AIDS are black, although the state's population         is only about 30 percent black. And almost 80 percent of new cases occur         among blacks. As a relatively poor, rural state, South Carolina ranks         eighth in the nation in the rate of AIDS cases.
 "Knowing         the facts about HIV and AIDS is an important part in fighting this disease,"         said Gardenia Ruff, director of the Office of Minority Health (OMH) at         the Department of Health and Environmental Control (DHEC). The CDC reports         that one in three people infected with HIV do not know their status. 
Just why         AIDS rates are so much higher among blacks has never been studied scientifically,         said Ericka Burroughs, who is also with the OMH. But poverty and STDs         are higher in black communities, and there is less access to quality health         care, according to an HIV prevention plan released by DHEC last year.
 The most         recent figures indicate about 10,360 people living with HIV/AIDS in South         Carolina. More than 17,000 cases have been reported since DHEC started         tracking the disease in the mid- 1980s. About 1,000 new cases are diagnosed         each year. Because in the early days of the epidemic AIDS was perceived         as a disease of gay white males, "African-Americans dissociated themselves         from being at risk and other races did as well," Burroughs said. "But         HIV is a behavior-related disease," she said.
 DHEC has         a community van traveling the state visiting communities with a high incidence         of syphilis or HIV, and it has provided more than 700 HIV tests since         June. Burroughs added, "If you don't have the money and can't pay, they         won't deny you the testing." 

**"Alcohol, Sexual Promiscuity Connected but Not Treated - Programs         Don't Link the Problems"**topUSA         Today (02.07.02) Karen Thomas 
 A new survey         shows that teens and young adults who use alcohol are seven times more         likely to have sex, and twice as likely to have sex with four or more         partners, than non-drinking teens. The survey of 1,200 13- to 24-year-olds         also indicates that nearly one out of four sexually active youths have         unprotected sex because they've been drinking or using drugs. Yet most         substance-abuse programs don't address sex, and most sex education classes         don't delve into substance use, says Joseph Califano, president of the         National Center on Addiction and Substance Abuse. Teens pay a heavy price         for that "tremendous disconnect," Califano says.
 The survey         from the Kaiser Family Foundation is one focus at a conference in New         York looking at the relationship between sex and drinking and using drugs.         Among other findings: More than one-quarter of youngsters age 15 to 17         (29 percent) say substance use influenced their decision to do something         sexual; more than a third (37 percent) of those 18 to 24 say drinking         or using drugs influenced them. Half of all teens and young adults say         "people their age" mix drugs or alcohol and sex "a lot." About one out         of four of those age 15 to 17 (24 percent) say they have "done more" sexually         than they planned because they were drinking or using drugs. It's even         more prevalent among those 18 to 24 (31 percent). 
According         to the Centers for Disease Control and Prevention, 79 percent of high         school students report having tried alcohol at least once. Half of ninth-         to 12th-graders have had sexual intercourse, and 65 percent will by the         time they graduate. Copies of the survey can be found on the Web at www.kff.org.         
**"Mbeki Resolute on AIDS Stance"**topBBC         News (02.08.02) 
         President Thabo Mbeki used his annual state of the nation address to call         for the moral regeneration of South Africa to combat the scourges of AIDS,         crime and poverty. But he once again dashed hope that he would change         the government's heavily criticized policy on antiretroviral drugs. His         speech is likely to disappoint a growing number of South Africans who         have urged him to change his AIDS policies. 
Mbeki said         he was committed to an intensified fight against AIDS but defended his         policy of not making antiretroviral drugs available to HIV-positive women         in state hospitals. Only about 10 percent of HIV-positive pregnant women         in South Africa have access to medication to prevent their babies from         infection. Critics blame Mbeki directly for this. In the past, Mbeki has         questioned the link between HIV and AIDS and dubbed antiretroviral drugs         as dangerous.
 On Thursday         former president Nelson Mandela spoke of the need for South Africa to         fight a war against HIV/AIDS and to confront the issue of mother-to-child         transmission; his remarks seemed to be a direct criticism of Mbeki. South         Africa has the single largest HIV-positive population in the world, estimated         at 5 million people, or 11 percent of its people. 

**"Tuberculosis Morbidity Among US-Born and Foreign-Born Populations         - United States, 2000"**topMorbidity         and Mortality Weekly Report (02.08.02) Vol. 51, No. 05, P. 101-4 Div         of Tuberculosis Elimination, NCHSTD/CDC.
 This report         summarizes data from the national TB surveillance system for 2000, compares         the data with data from 1992-1999, and explores critical underlying trends,         including continued high levels of TB among foreign-born individuals living         in the United States. 
In June 2001,         the CDC reported a 7 percent decline in the number of new TB cases reported         from 1999 to 2000, indicating continued progress in reducing TB in the         United States. While the number of reported TB cases has declined substantially         among US- born individuals, from 19,225 cases in 1992 to 8,714 cases in         2000, the number of cases in the foreign-born US population increased         from 7,270 cases in 1992 to 7,554 cases in 2000. The 2000 TB case rate         was 7 times greater in the foreign-born compared with the US-born. 
The number         of states with at least 50 percent of their annual total of TB cases among         the foreign-born increased from 4 in 1992 to 21 in 2000. Data also indicate         that while cases of multi-drug resistant (MDR) TB have been significantly         reduced, the remaining cases are increasingly concentrated among the foreign-born         population. Of the total number of reported MDR TB cases, the proportion         occurring in foreign-born persons increased from 31 percent in 1993 to         72 percent in 2000.
 In an editorial         note, the authors cautioned that data from the report are subject to at         least one limitation. Case rate by birth country should be interpreted         with caution because final population estimates based on April 2000 US         census data were not available. 
The authors         indicated that activities to address the high rate of TB in foreign-born         by the CDC, in collaboration with other national and international public         health organizations, are being undertaken. These include efforts 1) to         improve overseas screening by developing systematic tools for monitoring         and evaluating the screening process; 2) to improve the current notification         system that alerts local health departments about the arrival of immigrants         or refugees with suspected TB to assist them in obtaining a medical evaluation         and, if necessary, in completing a course of recommended drugs; 3) to         improve coordination of and communication about TB control activities         between the United States and Mexico to ensure completion of treatment         by patients who cross the border; and 4) to test recent arrivals from         high-incidence countries for latent TB infection and ensure completion         of treatment. National TB elimination activities will require broader         efforts to address the need of people with HIV, those with limited access         to health care, as well as those with housing and nutrition needs. 

**"Progress Toward Elimination of Perinatal HIV Infection - Michigan,         1993-2000"**topMorbidity         and Mortality Weekly Report (02.08.02) Vol. 51, No. 05, P. 94-7 E.D.         Mokotoff, MPH; B.H. Malamud, MPH; J.B. Kent, MS; R.J. Kowalczyk, MPH;         L.J. Scott; M.L. Lindergren, MD; T.A. Hammett, MPH 
 In 1994,         the US Public Health Service (PHS) issued guidelines for maternal and         neonatal zidovudine (ZDV) use to reduce perinatal human immunodeficiency         virus (HIV) transmission. The guidelines recommend maternal ZDV use during         the second and third trimesters of pregnancy and during labor and delivery         (L&D) and administration of ZDV to the neonate for the first 6 weeks of         life. In 2001, PHS updated 1995 guidelines for routine HIV counseling         and voluntary testing of pregnant women. The Michigan Department of Community         Health (MDCH) requires reporting of all children who are perinatally exposed         to HIV and it follows up these children to monitor their infection status         and record demographic, clinical, and laboratory characteristics. 
This report         summarizes data collected through December 31, 2001, on children born         to HIV-infected women in Michigan during 1993-2000. The report highlights         rapid adoption of PHS guidelines that have resulted in the reduction in         Michigan of perinatally acquired HIV infection from 19 percent (15 children)         in 1993 to 3 percent (2 children) in 2000. 
For birth         years 1993-2000, data were abstracted for 512 mother-infant pairs and         for six HIV-exposed infants for whom maternal information was unavailable.         The Michigan HIV/AIDS Registry (HARS) was matched to the Michigan Birth         Registry and identification of 39 HIV-exposed children was made possible.         For birth years 1993 and 1994 combined, the case ascertainment methods         identified 146 of 153 perinatally exposed infants when compared with available         data from that period from the Survey of Childbearing Women, an anonymous         serologic survey of the presence of maternal antibodies in all newborns.         Maternal records (i.e., Prenatal Care [PNC], clinic and L&D records) and         pediatric records were reviewed to complete and supplement information         collected from routine case reporting. 
On the basis         of follow-up of children for at least 12 months, the number of children         known to be perinatally HIV- infected decreased drastically from 1993         to 2000. Sufficient time has not elapsed to determine infection status         definitely for children born in 1999 and 2000, but most of those children         had one negative polymerase chain reaction test before age 4 months. Of         the 381 perinatally HIV-exposed children born during the years 1995-2000,         nine were reported to have AIDS by Jan. 1, 2002. 
Medical records         were reviewed for 488 HIV-infected women who gave birth during 1993-2000.         Of the 431 women with documented PNC information, 45 received no PNC (10         percent). Overall, 49 percent of women were tested for HIV before their         most recent pregnancy. Additional information on illegal drug and alcohol         use and STDs was available on 344 women. For all categories of PNC care,         cocaine and/or crack were the most frequently used illegal drugs. A high         proportion of women who had more than 3 PNC visits were diagnosed with         one or more STDs. 
According         to the editors, this report indicates that a high proportion of health-care         providers in Michigan are following PHS guidelines for maternal and neonatal         ZDV use to reduce perinatal HIV transmission. The high prevalence of STDs         and illegal drug and alcohol use among HIV infected women suggest that         medical practitioners need to provide treatment appropriate care referrals         for HIV-infected women to manage their HIV infection, substance abuse,         and other conditions. 
The CDC provides         funds to 21 states to collect expanded perinatal surveillance data as         part of a comprehensive public health effort to further reduce rates of         perinatal transmission. 

**"World Bank Gives African Countries $500         Million for AIDS Fight"**topAssociated         Press (02.07.02)          African countries will receive a $500 million zero-interest loan from         the World Bank to combat AIDS. Thursday's decision by its 183-nation board         of directors brings lending to Africa under the Multi-Country HIV/AIDS         Program for Africa to $1 billion for the current fiscal year. The funds,         disbursed under the International Development Association, will be used         for prevention, treatment, and support programs in 12 to 15 sub- Saharan         African countries, the bank said. It will include $30 million in credit         for a project in Senegal. The World Bank and UNAIDS estimate that approximately         $3 billion is needed annually to fund basic prevention, treatment and         support programs for HIV/AIDS. 

**"AIDS Researcher Donates $1 Million Prize to UBC Professorship"**topVancouver         Sun (02.05.02) John Armstrong 
 A Vancouver         researcher who was awarded $1 million for his pioneering work in developing         new AIDS treatments will use the money to endow a professorship in AIDS         research at the University of British Columbia. The pharmaceutical company         Boehringer Ingelheim (Canada) announced the inaugural $1 million award         for Dr. Julio Montaner, who is director of clinical activities for the         BC Center for Excellence in HIV/AIDS at St. Paul's Hospital and a professor         of medicine at the university. Montaner heads a team of scientists that         late last year announced an advance in HIV treatment by using finely tuned         doses of anti-viral drugs. By using gene-mapping to monitor a patient's         immune system for drug resistance, it was possible to tailor individual         drug dosages for patients, reducing side effects and saving money by delivering         precise amounts of the expensive medications. 

**"Local AIDS Service Group Awarded $15,000 Grant"**topWashington         Blade (02.01.02)          P.L. Active, a Washington, D.C., AIDS service organization, has been awarded         a $15,000 grant from St. Thomas' Parish, an Episcopal congregation in         the city's Dupont Circle area. The funds will go to support P.L. Active's         drug assistance program for people living with HIV/AIDS. The program helps         pay for prescription medications, supplies and equipment, as well as over-the-counter         items such as vitamins, purified water, and food supplements. **Send         Us Your Feedback**We'd like to know what you think of the         Prevention News Update.         Please take a minute to send an e-mail with your comments to [email protected].         With your help, we will continue to         improve this service to better meet your information needs. 
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